Real-world comparative outcomes of first-line immune combinations (ICI-ICI vs ICI-TKI) in metastatic renal cell carcinoma with sarcomatoid features.
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Rebuzzi Sara Elena, Di Costanzo Fabrizio, Filippi Roberto, Rescigno Pasquale, Fornarini Giuseppe, Signori Alessio, Masini Cristina, Iacovelli Roberto, Fanelli Martina, Dalla Volta Alberto, Di Napoli Marilena, Roviello Giandomenico, Guida Annalisa, Lolli Cristian, Caserta Claudia, Berardi Rossana, Sorarù Mariella, Lombardo Laura, Pierantoni Francesco, Verzoni Elena, Mennitto Alessia, Scagliarini Sarah, Tucci Marcello, Vitale Maria Giuseppa, Messina Carlo, Bonomi Lucia, Tondulli Luca, Deppieri Filippo Maria, La Russa Francesca, Formisano Luigi, Ortega Cinzia, Maiorano Brigida Anna, Dri Arianna, Zai Silvia, Cocorocchio Emilia, De Tursi Michele, Fantinel Emanuela, Conteduca Vincenza, Nasso Cecilia, Sansi Camilla, Nolè Franco, Zago Giulia, Bronte Enrico, Bozza Giovanni, Bertolotti Francesca, Montobbio Noemi, Banna Giuseppe Luigi, Buti Sebastiano, Bimbatti Davide
Аннотация
METHODS: The Meet-URO 33 is an Italian multicenter retrospective/prospective observational study enrolling patients with mRCC receiving first-line systemic therapy in routine clinical practice. In the present sub-analysis, objective response and survival outcomes were compared between ICI-ICI and ICI-TKI regimens in patients with documented sarcomatoid differentiation and IMDC intermediate-/poor-risk disease.
RESULTS: Among 1695 patients enrolled from 58 centers, 180 (10.6%) had sRCC and among them, 107 (58.2%) were intermediate-risk and 56 (30.4%) were poor-risk. With a median follow-up of 21.8 months, in the I/P-sRCC population with available data (n = 155), univariable analysis showed longer overall survival (OS) with ICI-ICI compared to ICI-TKI (HR 0.58, p = 0.04). However, in propensity score-weighted analyses, point estimates slightly favored ICI-ICI, but no statistically significant differences were observed for OS, PFS, or ORR.
CONCLUSIONS: In this real-world analysis comparing ICI-ICI and ICI-TKI in sarcomatoid mRCC, propensity score-weighted models showed no statistically significant differences between treatment combinations on clinical outcomes. These findings highlight the relevance of baseline disease and patients characteristics in shaping treatment outcomes and confirm the effectiveness of ICI-containing combinations in the treatment of sarcomatoid mRCC.